Mental health check-ins & screening

A mental health screening is usually a short set of questions about how you have been feeling, sleeping and coping. It is a quick way for a doctor or nurse to notice if you might need more support. It is not a test you can pass or fail, and it is not a diagnosis.

In the U.S., an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) recommends regular depression screening for adults and teens, and anxiety screening for adults up to 64 and for children and teens aged 8 to 18. Screening works best when it is followed by care if it is needed.

Many people don’t know where to start. NIMH suggests starting with your primary care provider, who can refer you to a mental health professional. Even if they don’t ask first, you can bring it up.

Before and during the visit

1. Write down your questions and concerns. Appointments are short.
2. Note what you have noticed: how you feel, when it started, how often it happens and how much it affects daily life.
3. Think about your family’s mental health history, since it can affect your risk.
4. Consider bringing a friend or relative to support you and take notes.
5. Be honest, including about big stresses or recent changes in your life.
6. Ask questions. If something doesn’t feel right, say so and ask about other options.

Most of us check the weather, our phone battery and our bank balance. Checking in on our own mental health is just as useful. A short weekly check-in helps you spot changes early, before they grow.

It works because it turns vague feelings (“I’ve been off lately”) into something you can see. When you write it down each week, slow changes become easier to notice.

Your five-minute weekly check-in

1. Pick the same time each week, like Sunday evening. Sit somewhere quiet.
2. Rate your mood this week from 0 (very low) to 10 (great).
3. Ask about your basics: How did I sleep? Did I eat regularly? Did I move my body?
4. Ask about people: Who did I talk to? Did I feel close to anyone, or very alone?
5. Ask about stress: What felt heavy this week? What helped?
6. Compare with last week: Is anything changing? Has something lasted two weeks or more?
7. Choose one small thing to do next week, like an early night or calling a friend.

A traffic-light guide

• Green: mostly OK. Keep doing what helps.
• Yellow: some changes or a hard week. Add extra self-care, talk to someone you trust, and check again next week.
• Red: things have been hard for two weeks or more, are getting worse, or you can’t manage daily life. Talk to a doctor, counselor or your clinical provider.

Self-care that helps when you are in the green or yellow

• Move: even a 30-minute walk each day can lift mood
• Keep a regular sleep schedule and limit screens before bed
• Eat regular, balanced meals and drink enough water
• Make time for something relaxing: music, nature, a hobby
• Name a few things you are grateful for
• Reach out to friends or family

You don’t need to be an expert to help someone. Often, the most useful thing is simply noticing, asking and listening. Many people who are struggling are waiting for someone to ask.

A simple way to check in

1. Pick a good moment: somewhere private and calm, with time to talk. A walk or a drive can feel easier than face to face.
2. Say what you noticed, gently: “You’ve seemed quieter lately. How are you really doing?”
3. Listen more than you talk. Let them finish. You don’t need to fix anything.
4. Show you care: “That sounds really hard. Thank you for telling me.”
5. Ask what would help: “Is there anything I can do?” or “Would it help to talk to someone?”
6. Offer practical help, like finding a counselor together or going with them to an appointment.
7. Follow up in a few days with a call or message.

Helpful things to say

• “I’m here for you.”
• “You don’t have to go through this alone.”
• “I’m not going anywhere.”
• “What has been the hardest part?”
• “Would you like help finding someone to talk to?”

Things to avoid

• Telling them to “cheer up” or “snap out of it”
• Comparing their struggle to someone else’s
• Jumping straight to advice before you have listened
• Promising to keep it secret if their safety is at risk
• Making it all about you

If you are worried someone may be thinking about suicide, it is OK to ask them directly. Asking does not put the idea in their head. It shows you care and opens the door to help. The Helping someone who may be suicidal guide explains the five #BeThe1To steps.

Most of us know a little about physical first aid. Mental Health First Aid (MHFA) is the same idea for mental health: a course that teaches people how to recognize, understand and respond to signs of mental health or substance use challenges, and give first support until professional help is in place.

In the United States, it is run by the National Council for Mental Wellbeing. It started in Australia in 2001 and came to the U.S. in 2008. More than 5 million people across the U.S. have been trained.

The ALGEE action plan

• A: Approach the person, and assess for risk of suicide or harm
• L: Listen without judging
• G: Give reassurance and information
• E: Encourage appropriate professional help
• E: Encourage self-help and other support strategies

The steps can be used in any order. The idea is simple: notice, care, listen and connect people with support.

Course options

• Adult MHFA, with versions for groups like veterans, older adults, rural communities and public safety
• Youth MHFA, focused on helping young people
• Teen MHFA, for teens helping other teens
• MHFA at Work, for workplaces
• In person (about a day) or blended (2 hours online, then a half-day session)

In 2022, only about half (50.6%) of U.S. adults living with a mental illness received mental health treatment in the past year. There are many reasons why. Knowing the common barriers, and the ways around them, can help.

Myth: A mental health screening is a test you can fail.

• Fact: A screening is a short set of questions that helps your provider notice if you might need more support. It is not a diagnosis.

Myth: Only people who already feel unwell get screened.

• Fact: Screening is recommended for adults and teens who have no known mental health condition, so changes can be caught early.

Myth: Asking someone if they are OK will make things worse.

• Fact: Asking shows you care. Even asking directly about suicide does not put the idea in someone’s head.

Myth: You need special training to help someone who is struggling.

• Fact: Noticing, asking and listening help a lot. Courses like Mental Health First Aid can build your confidence, but First Aiders don’t diagnose. They help connect people with professional care.

Myth: An online quiz can tell you what you have.

• Fact: Online screens give a quick snapshot at most. Only a qualified professional can give a full assessment.

Myth: Mental health care is always too expensive.

• Fact: Marketplace plans and many other U.S. health plans must cover depression screening at no cost, Medicare covers a yearly screening, and free helplines can point you to low-cost care.

Self-care helps with everyday stress. But sometimes, it isn’t enough, and that is OK. Needing professional help is not a weakness, just as seeing a doctor for a broken arm is not a weakness.

Consider talking to a professional if

• Hard feelings or changes have lasted two weeks or more
• Things are getting worse, not better
• Self-care is not helping
• It is hard to manage school, work, home or relationships
• You are using alcohol or other substances to cope
• People close to you are worried about you

Where to start

• Your doctor or clinical provider (a good first stop for many people)
• A school counselor, nurse or college counseling center
• A therapist, counselor or psychologist
• An employee assistance program at work, if you have one
• A community health center, which offers lower-cost care
• A peer support group

Talking therapies help many people learn new ways to cope, understand their feelings and make changes. For anything medical, consult with your clinical provider.

Free lines that can point you to help (U.S.)

• 211: call 211 for local services, including mental health and health care costs
• 988 Suicide & Crisis Lifeline: call or text 988, any time
• National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA (1-833-852-6262)
• SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7), or text your ZIP code to 435748

Outside the U.S., findahelpline.com lists free, confidential helplines in many countries. You can search by country and by topic.

Getting help

Screening